Point-of-care testing for malaria outbreak management

• Published in: Transactions of the Royal Society of Tropical Medicine and Hygiene Vol. 102; no. 7; pp. 699 - 704
• Main Authors: Ratnawati, Hatta, Mochammad, Smits, Henk L.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-07-2008; Elsevier
• Subjects: Adolescent; Adult; Animals; Antigens, Protozoan - analysis; Biological and medical sciences; Child; Disease Outbreaks - prevention & control; Female; General aspects; Human protozoal diseases; Humans; Indonesia; Infectious diseases; Malaria; Malaria, Falciparum - diagnosis; Malaria, Falciparum - epidemiology; Malaria, Vivax - diagnosis; Malaria, Vivax - epidemiology; Male; Medical sciences; Microscopy - methods; Middle Aged; Outbreak management; Parasitemia - diagnosis; Parasitic diseases; Plasmodium falciparum; Plasmodium falciparum - isolation & purification; Plasmodium vivax; Plasmodium vivax - isolation & purification; Point of care; Point-of-Care Systems - standards; Protozoal diseases; Reagent Kits, Diagnostic - economics; Reagent Kits, Diagnostic - standards; Sensitivity and Specificity; Time Factors; Asia; Indonesia; Plasmodium falciparum; Plasmodium vivax; Outbreak management; Malaria; Point of care; Indonesia; Epidemic; Protozoa; Point-of-care testing; Apicomplexa; Protozoal disease; Parasitosis; Infection; Treatment; Point of care testing; Tropical medicine; Public health
• ISSN: 0035-9203; 1878-3503
• DOI: 10.1016/j.trstmh.2008.04.018

A rapid antigen assay for malaria was performed on blood samples collected during a simultaneous outbreak of falciparum malaria and vivax malaria on a remote island in the Indonesian archipelago. During the outbreak, a total of 89 patients (4.3% of the population) were diagnosed with malaria within a week. Microscopic examination revealed 78 malaria slide-positive cases, of whom 49 (62.8%) were identified as
P. falciparum, 7 (9.0%) as
P. vivax and 22 (28.2%) as mixed
P. falciparum and
P. vivax infections. The rapid malaria assay showed excellent correlation with expert-confirmed routine microscopy for
P. falciparum and
P. vivax monoinfections and mixed infections with a parasite density >50
parasites/μl. Several slide-negative blood samples collected from febrile patients with clinical malaria tested positive in the rapid test. The estimated sensitivity calculated for the rapid test (91.0%) was slightly higher than that of microscopy (87.6%). The result indicates that rapid antigen detection for malaria could be a useful alternative to microscopy to reduce the workload during emergency outbreak situations.